Sustainable Health Care - who bears the real cost of care?

Thursday, March 5, 2015

Sustainability in health care

We've talked about choice and transparency as being fundamental principles of sustainable health. But what about the cost of providing health care? Is the cost of providing health care sustainable? For instance, is it possible for a patient to receive health care services without a residual bill? What if a patient has multiple health problems and sees multiple doctors. Are they able to receive these services and use their insurance coverage to pay for those services? Unfortunately, this is rarely the case.

As an example, let's take a look at my friend Danny (name changed). I diagnosed Danny 25 years ago with vasculitis. Since that time he has been unable to work and has subsequently gone on social security disability. Late last year Danny didn't feel well. He was pale and short of breath. He went to our local emergency room with symptoms of what appeared to be a heart attack. Upon evaluation in the ER they determined that Danny had severe coronary artery blockage and was life flighted to our regional medical center where he underwent coronary artery bypass surgery. Prior to surgery Danny asked his care givers about the costs of his care and was reassured that he would be covered.

Danny's better now with one exception. He almost had another heart attack when he received the bill for his care. He now owes $12,000 to the hospital. When he spoke to the billing department at the hospital and told them that his only income was social security disability they advised him that they intended to garnish his income.

Contemporary health care has developed a new economic model. The model is to proceed with business as usual knowing that the burden of cost can be shifted onto the shoulders of the consumer. But think for a moment of what this does to the economy as a whole. In Danny's case, sure, he's alive as a direct result of his care. But now he is a financial cripple. Just like Danny, literally thousands of people are being crippled by health care cost every day. The outcome is that the cost of paying for health care is now the number one reason that consumers file for personal bankruptcy. The price we pay for health care as consumers creates a huge drag on the overall economy.

There were many players in Danny's care, some who added to his care and others who took away from that care. And they should be justly compensated for their hard work. There were doctors, nurses, hospitals and most importantly, Danny himself. But in Danny's case, the balance sheet doesn't lie. There's simply nothing left of health care for Danny. And now the health care system wants more from him that what he is able to give. As such, the cost of health care is simply not sustainable.